Direct puncture embolization of a medulla oblongata hemangioblastoma

Hemangioblastoma is a rare tumor of vascular origin, most commonly located in the posterior fossa, which presents with severe symptoms and usually very hard to resect without remarkable operative blood loss.1, 2 Pre-operative embolization may decrease the amount of intra-operative bleeding, but the endovascular treatment of such tumor may be very challenging due to the high risk of infarction of the surrounding tissues. Direct puncture embolization has been developed to overcome many of the limitations of endovascular techniques for many hypervascular lesions, also hemangioblastomas.3, 4, 5 We present in this Technical Video (video 1) a direct puncture embolization with balloon-protection of a hemangioblastoma of the medulla oblongata using Onyx 18 (Medtronic, inc.) as sole liquid embolic agent.